title: Newborn length predicts early infant linear growth retardation and disproportionately high weight gain in a low-income population.
abstract: BACKGROUND
  Stunting is prevalent by the age of 6 months in the indigenous population of the Western Highlands of Guatemala.
  
  
  OBJECTIVE
  The objective of this study was to determine the time course and predictors of linear growth failure and weight-for-age in early infancy.
  
  
  METHODS
  One hundred and forty eight term newborns had measurements of length and weight in their homes, repeated at 3 and 6 months. Maternal measurements were also obtained.
  
  
  RESULTS
  Mean ± SD length-for-age Z-score (LAZ) declined from newborn -1.0 ± 1.01 to -2.20 ± 1.05 and -2.26 ± 1.01 at 3 and 6 months respectively. Stunting rates for newborn, 3 and 6 months were 47%, 53% and 56% respectively. A multiple regression model (R(2) = 0.64) demonstrated that the major predictor of LAZ at 3 months was newborn LAZ with the other predictors being newborn weight-for-age Z-score (WAZ), gender and maternal education∗maternal age interaction. Because WAZ remained essentially constant and LAZ declined during the same period, weight-for-length Z-score (WLZ) increased from -0.44 to +1.28 from birth to 3 months. The more severe the linear growth failure, the greater WAZ was in proportion to the LAZ.
  
  
  CONCLUSIONS
  The primary conclusion is that impaired fetal linear growth is the major predictor of early infant linear growth failure indicating that prevention needs to start with maternal interventions.
authors.affiliation: University of Colorado Denver, 12700 East 19th Avenue, Box C225, Aurora, CO 80045, United States.
authors.forename: Samuel Clark
authors.initials: SC
authors.lastname: Berngard
authors.forename: Jennifer Bishop
authors.initials: JB
authors.lastname: Berngard
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Krebs
authors.forename: Ana
authors.initials: A
authors.lastname: Garcés
authors.forename: Leland V
authors.initials: LV
authors.lastname: Miller
authors.forename: Jamie
authors.initials: J
authors.lastname: Westcott
authors.forename: Linda L
authors.initials: LL
authors.lastname: Wright
authors.forename: Mark
authors.initials: M
authors.lastname: Kindem
authors.forename: K Michael
authors.initials: KM
authors.lastname: Hambidge
mesh_terms: D000367:Age Factors; D049628:Body Size; D003430:Cross-Sectional Studies; D006130:Growth Disorders / Q000503:physiopathology*; D006166:Guatemala; D006801:Humans; D007231:Infant, Newborn; D016014:Linear Models; D008137:Longitudinal Studies; D044382:Population Groups / Q000706:statistics & numerical data*; D011203:Poverty / Q000706:statistics & numerical data*; D015430:Weight Gain / Q000502:physiology*
keywords: AIC; Akaike Information Criterion; Birth weight; IFS; IUGR; Infant growth; LAZ; LMP; Linear growth; Predictors of infant growth; SES; VIF; WAZ; WLZ; intra-uterine growth retardation; iron folate supplement; last menstrual period; length-for-age Z-score; socio-economic status; variance inflation factor; weight-for-age Z-score; weight-for-length Z-score